No abstract available.

BACKGROUND: In 1996, our emergency department(ED) had 148.4 patients per day and an average time for managing simple and uncomplicated patients was 248 minutes. To relieve congestion, delay and conflict in ED, we have developed Fast Track to treat patients with minor illness rapidly and effectively. The Fast Track area is located in a separate area in front to the main department. The efficiency and effectiveness of new system and patients satisfaction were investigated. METHODS: All ambulatory patients(> 15 years of age) were triaged and treated at Fast Track by emergency physicians. Patients, triaged as severe illness, were moved directly to main ED and the other patients with minor illness were managed in Fast Track. We analysed the patients who were managed at Fast Track from Jan. 1st 1997 through Nov. 30th 1997. The total time staying in Fast Track from beginning of trige to final decision such as discharge or admission was recorded retrospectively. A questionnaire was obtained from random patients in the same period to evaluate the patient's satisfaction. RESULTS: The number of patients who were managed in Fast Track was 13,378, and it was 55.8% of all adult patients who visited ED during the period. The average staying time was decreased significantly with time, (140.9+/-2.9 minutes in June, 125.4+/-2.8 minutes in July, and 97.7+/-1.0 minutes after July). The 75 percentile weighted average time was also decreased significantly; 196 minutes in June, 107 minutes in July, 135 minutes from August to November(p<0.01). The questionnaire were obtained from 107 patients. The results were revealed that 90 of 107 patients(84.1%) were satisfied with emergency care at Fast Track, and the remaining patients expressed unsatisfied comments such as long waiting time(4.7%), overcrowding(1.9%), unsatisfactory care(1.9%). CONCLUSION: The Fast Track system could decrease patient's staying time and improve patient's satisfaction. In addition, the efficiency and effectiveness of the acute care in ED would be enhanced by managing minor illness in Fast Track rapidly and effectively.
Adult ; Emergencies* ; Emergency Medical Services ; Emergency Service, Hospital* ; Estrogens, Conjugated (USP) ; Humans ; Surveys and Questionnaires ; Retrospective Studies ; Tertiary Care Centers*

The purpose of this study was to provide fundamental data by figuring out fatigue differences in patients on hemodialysis and peritoneal dialysis. The subjects for this study were 49 patients on hemodialysis and 54 patients on peritioneal dialysis at C university medical center in Seoul Results were as follows: 1. The average fatigue score in peritoneal dialysis patients tended to be higher in patients on peritoneal dialysis(42.22) than in patients on hemodialysis(39.41). Peritoneal dialysis patients showed higher score than hemodialysis patients in some general characteristics in groups with male, ones in 20's, 40's, 50's, married, college degree, having religion, having occupation, and not take regular nap. 2. The percents of this subjects with feel fatigue at the time of survey was higher in peritoneal dialysis patients(68.5%) than in hemodialysis patients(57.1%). The percentages of the subjects who feel fatigue in peritioneal dialysis patients was higher than hemodialysis patients, and the high tendencies in peritoneal dialysis patients in were obsemed in groups with male, ones in 30's, to have college degree, periods so of 1-2years in peritoneal dialysis, region, men without occupation, regular exercises, regular nap etc.
Academic Medical Centers ; Dialysis* ; Exercise ; Fatigue* ; Humans ; Male ; Occupations ; Peritoneal Dialysis ; Renal Dialysis ; Seoul

No abstract available.
Humans ; Nursing* ; Students, Nursing*

The object of this study was to determine the radiation effect on the urinary bladder and to establish the basic date for optimal fraction schedule on the whole abdominal irradiation of the mice. Although radiation damage of the urinary bladder is one of the dose-limiting factor for treatment of lower abdominal cancer, such as uterine cervical or rectal cancer, systematic histopathological study of total dose and recovery duration is very rare, especially in conventional fractionation regimen of clinical use. Authors used 198 mice and analyzed histopathological findings according to total dose (40&50 GY) and recovery duration (1-15 weeks after completion of irradiation) The results were summarized as follows: 1. No definite difference of radiosensitivity was noted between male and female group. 2. Most of mucosal injuries were recovered within 14 weeks in 40 GY irradiated group. 3. Vascular injury and change of connective tissue were prominent and persisted even mild degree until 15 weeks after completion of irradiation in 50 GY irradiated group. 4. Although follow up duration of this study (105 days) was not enough to compare life span of mice, this study emphasized that precious schedule for treatment planning was necessary for preventing or reducing of late complication.
Animals ; Appointments and Schedules ; Connective Tissue ; Female ; Follow-Up Studies ; Humans ; Male ; Mice* ; Radiation Effects ; Radiation Tolerance ; Rectal Neoplasms ; Urinary Bladder* ; Vascular System Injuries

No abstract available.
Blood Platelets* ; Humans ; Infant, Newborn ; Infant, Premature* ; Phototherapy* ; Platelet Count*

Many articles concerning the accuracy of diagnosis of malignant tumor cells in body fluids have appeared in the literature, but few authors have attempted to describe the characteristics of these cells to determine the site of the primary tumor as they relate to tumors of specific primary sites. This paper presents the results of a retrospective study on malignant body cavity effusions of which the primary site was established on the basis of either biopsy or surgical resection of the primary neoplasm during the period of 6 years beginning from January 1983 to December 1988. The results obtained are summarized as follows: 1) The 143 fluid specimens from 129 patients were composed of 51 cases of pleural, 69 of peritoneal, and 9 of pericardial origin. 2) Adenocarcinoma was the most frequent type of malignant effusions (78.3%). The most common primary site was the lung (50%) in pleural fluid and stomach (55.2%) in ascites. 3) The results of this study show that the primary site of tumor cells can be identified in the body fluid of accurate cytomorphologic criteria are used. Identification of the primary site of an effusion would be improved by the consideration of clinical information
Adenocarcinoma ; Biopsy

Leiomyomas are benign tumors of smooth muscle origin and are very rare in the female genital tract. To date, approximately 35 cases of urethral leiomyoma have been reported in the literature. A 34-year-old woman presented with a 3-year history of a mass at the urethral meatus. Physical examination showed 2 x 1.5 cm lump at the urethral meatus, posterior lip. Histologically the tumor was mainly composed of benign cigar shaped smooth muscle izells which were arranged in interlacing fascicles without cellular atypia or mitosis. Immunohistochemistry confirmed leiomyoma with positive staining for vimentin, desmin and muscle specific actin.
Female ; Humans

One of the most important factors leading to a successful healing of rotator cuff tear is good bone quality to secure the suture anchor in the bone for a stable fixation. However, rotator cuff tear are commonly found in elderly patients, and their proximal humerus often shows osteoporosis or cystic lesions. Especially when the transosseous repair prevails for a torn rotator cuff, a weak metaphyseal cancellous bone is often the case, which associated with difficulty in stable fixation of the lateral row suture anchor. In this situation, we were able to augment the lateral row fixation with polymethylmethacrylate bone cement. Although there is a concern of disturbance in the blood flow and healing potential, our case showed good clinical results with respect to healing. If we suspect a weak fixation of the lateral row suture anchor, bone cement seems to be a good option for augmentation.
Aged ; Bone Cements ; Humans ; Humerus ; Osteoporosis ; Polymethyl Methacrylate ; Rotator Cuff* ; Suture Anchors ; Tears

No abstract available.
Multivariate Analysis* ; Tooth*